Display options
Cite
Paoli CJ, Reynolds MA, Coles C, et al. Predicted Economic Benefits of a Novel Biomarker for Earlier Sepsis Identification and Treatment: A Counterfactual Analysis. Crit Care Explor. 2019;1(8):e0029doi: 10.1097/CCE.0000000000000029.
Paoli, C. J., Reynolds, M. A., Coles, C., Gitlin, M., & Crouser, E. (2019). Predicted Economic Benefits of a Novel Biomarker for Earlier Sepsis Identification and Treatment: A Counterfactual Analysis. Critical care explorations, 1(8), e0029. https://doi.org/10.1097/CCE.0000000000000029
Paoli, Carly J, et al. "Predicted Economic Benefits of a Novel Biomarker for Earlier Sepsis Identification and Treatment: A Counterfactual Analysis." Critical care explorations vol. 1,8 (2019): e0029. doi: https://doi.org/10.1097/CCE.0000000000000029
Paoli CJ, Reynolds MA, Coles C, Gitlin M, Crouser E. Predicted Economic Benefits of a Novel Biomarker for Earlier Sepsis Identification and Treatment: A Counterfactual Analysis. Crit Care Explor. 2019 Aug 07;1(8):e0029. doi: 10.1097/CCE.0000000000000029. eCollection 2019 Aug. PMID: 32166270; PMCID: PMC7063955.
Copy Download .nbib Format: NLM
Share it on

Crit Care Explor. 2019 Aug 07;1(8):e0029. doi: 10.1097/CCE.0000000000000029. eCollection 2019 Aug.

Predicted Economic Benefits of a Novel Biomarker for Earlier Sepsis Identification and Treatment: A Counterfactual Analysis.

Critical care explorations

Carly J Paoli, Mark A Reynolds, Courtney Coles, Matthew Gitlin, Elliott Crouser

Affiliations

  1. Health Economics & Reimbursement, Beckman Coulter, Inc., Brea, CA.
  2. Blue Path Solutions, Los Angeles, CA.
  3. Critical Care Medicine, Ohio State University Wexner Medical Center, Columbus, OH.

PMID: 32166270 PMCID: PMC7063955 DOI: 10.1097/CCE.0000000000000029

Abstract

To estimate the potential clinical and health economic value of earlier sepsis identification in the emergency department using a novel diagnostic marker, monocyte distribution width.

DESIGN: The analysis was conducted in two phases: 1) an analysis of the pivotal registration trial evidence to estimate the potential benefit of monocyte distribution width for early sepsis identification and (2) a cost-consequence analysis to estimate the potential economic and clinical benefits that could have resulted from earlier administration of antibiotics for those patients.

SETTING: Sepsis identified in the emergency department which led to inpatient hospitalizations.

PATIENTS: Adult sepsis patients admitted through the emergency department.

INTERVENTIONS: None. This was a model simulation of clinical and economic outcomes of monocyte distribution width based on results from a noninterventional, multicenter clinical trial.

MEASUREMENTS AND MAIN RESULTS: Among the 385 patients with sepsis, a total of 349 were eligible for inclusion. Sixty-seven percent of patients were predicted to benefit from monocyte distribution width results, resulting in an estimated mean reduction in time to antibiotics administration from 3.98 hours using standard of care to 2.07 hours using monocyte distribution width + standard of care. Based on this simulated reduction in time to antibiotics, monocyte distribution width + standard of care could have resulted in a less than or equal to 14.2% reduction (27.9% vs 32.5%) in mortality, a mean reduction of 1.48 days (10.0 vs 11.5 d) in length of stay, and $3,460 ($23,466 vs $26,926) savings per hospitalization. At the hospital level, based on an established national mean of 206 sepsis hospitalizations per hospital per year, earlier identification with monocyte distribution width is predicted to result in a total of $712,783 in annual cost savings per hospital.

CONCLUSIONS: Improved early identification of sepsis using monocyte distribution width along with current standard of care is estimated to improve both clinical and economic outcomes of sepsis patients presenting in the emergency department. Further research is warranted to confirm these model projections.

Copyright © 2019 The Authors. Published by Wolters Kluwer Health, Inc. on behalf of the Society of Critical Care Medicine.

Keywords: antibiotics; cost analysis; costs; early treatment; performance improvement; sepsis

References

  1. JAMA. 2016 Feb 23;315(8):801-10 - PubMed
  2. Am J Emerg Med. 2018 Oct;36(10):1745-1748 - PubMed
  3. Emerg Med Clin North Am. 2017 Feb;35(1):219-231 - PubMed
  4. Crit Care Med. 2016 Oct;44(10):e1004 - PubMed
  5. Crit Care Med. 2019 Aug;47(8):1018-1025 - PubMed
  6. BMJ Qual Saf. 2015 Dec;24(12):787-95 - PubMed
  7. Crit Care Med. 2011 Jun;39(6):1306-12 - PubMed
  8. Crit Care Med. 2018 Dec;46(12):1889-1897 - PubMed
  9. Am J Emerg Med. 2016 Jan;34(1):1-9 - PubMed
  10. Expert Rev Mol Diagn. 2017 Jun;17(6):593-601 - PubMed
  11. J Med Econ. 2017 Jun;20(6):646-651 - PubMed
  12. Crit Care Med. 2007 May;35(5):1257-62 - PubMed
  13. Crit Care Med. 2017 May;45(5):759-765 - PubMed
  14. Lancet Infect Dis. 2013 May;13(5):426-35 - PubMed
  15. Crit Care Med. 2013 May;41(5):1167-74 - PubMed
  16. Chest. 2017 Sep;152(3):518-526 - PubMed
  17. Crit Care Med. 2014 Aug;42(8):1749-55 - PubMed
  18. N Engl J Med. 2017 Jun 8;376(23):2235-2244 - PubMed
  19. J Healthc Qual. 2017 Nov/Dec;39(6):322-333 - PubMed
  20. Intensive Care Med. 2018 Jun;44(6):925-928 - PubMed
  21. Ann Pharmacother. 2014 Oct;48(10):1269-75 - PubMed
  22. Ann Emerg Med. 2011 May;57(5):500-4 - PubMed
  23. Clin Chem Lab Med. 2015 Mar;53(4):583-92 - PubMed
  24. JAMA. 2017 Oct 3;318(13):1241-1249 - PubMed
  25. Pharmacoeconomics. 1998 Mar;13(3):277-88 - PubMed
  26. Crit Care Med. 2018 Apr;46(4):500-505 - PubMed
  27. Crit Care Med. 2006 Jun;34(6):1589-96 - PubMed
  28. JAMA. 2017 Feb 28;317(8):807-808 - PubMed
  29. Lancet Infect Dis. 2007 Mar;7(3):210-7 - PubMed
  30. PeerJ. 2014 Apr 10;2:e343 - PubMed
  31. Intensive Care Med. 2014 Nov;40(11):1623-33 - PubMed
  32. JAMA. 2014 Jul 2;312(1):90-2 - PubMed
  33. Clin Microbiol Infect. 2015 May;21(5):474-81 - PubMed
  34. Crit Care Med. 2018 May;46(5):e426-e434 - PubMed
  35. BMJ Open Respir Res. 2017 Nov 9;4(1):e000234 - PubMed
  36. Am J Emerg Med. 2016 Feb;34(2):185-8 - PubMed

Publication Types